| NPI | 1578176277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS A PORTO Owner/CEO 508-478-2610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology MOHS-Micrographic Surgery |
| 207ND0900X Dermatology Dermatopathology | |
| 207NS0135X Dermatology Procedural Dermatology | |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |